{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:38:10Z","timestamp":1787236690670,"version":"build-2736575974"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Day programmes for adolescent anorexia nervosa (AN) can function as an alternative to inpatient admissions and\/or an increase in outpatient treatment intensity. Processes of change during treatment for AN are currently poorly understood. This study aimed to explore how adolescents with AN and their parents understood the helpful and unhelpful factors and processes that impacted them during day programme treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A critical realist paradigm was used to qualitatively explore the views of 16 participants. Participants were recruited from the Intensive Treatment Programme (ITP) at the Maudsley Center for Child and Adolescent Eating Disorders (MCCAED) at the end of treatment. Dyadic Interview Analysis (DIA) was used to compare and contrast the narratives of the seven adolescent\u2013parent pairs after two inductive reflexive thematic analyses were conducted for the group of eight adolescents and the group of eight parents separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight subthemes across three themes were identified: 1) \u201c\n                      <jats:italic>Like me she didn't feel so alone anymore<\/jats:italic>\n                      \u201d\u2014families connect with staff, peers, and each other; 2) \u201c\n                      <jats:italic>You have to eat because ITP say so<\/jats:italic>\n                      \u201d\u2014the programme provides families with containment through its structure and authority; and 3) \u201c\n                      <jats:italic>I found that I was using the skills I learnt there like in multiple aspects of my life, not just around food\u201d<\/jats:italic>\n                      \u2014families take in new ideas and generalize these into their lives. These interconnected themes generated hope and change. However, helpful elements individually could be unhelpful if one or more of the other factors were missing. For example, staff firmness, which participants often found helpful (theme two), could be experienced as harshness when adolescents did not feel related to as individuals (theme one).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings can be conceptualized within recent descriptions regarding the therapeutic change, including epistemic trust and mentalization. Treatment characteristics, such as intensity and containment, as well as illness-specific factors and processes, such as control and collaboration, the role of peer support, and the potential for family members to experience the impact of the adolescent's AN and treatment non-response as traumatic, are equally important to consider.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2023.1226605","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T04:04:58Z","timestamp":1691726698000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Change processes during intensive day programme treatment for adolescent anorexia nervosa: a dyadic interview analysis of adolescent and parent views"],"prefix":"10.3389","volume":"14","author":[{"given":"Amy","family":"Colla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Baudinet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny","family":"Cavenagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Senra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Goddard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"B1","first-page":"947","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5","year":"2013"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2095","DOI":"10.1002\/eat.23616","article-title":"Multi-family therapy for eating disorders: a systematic scoping review of the quantitative and qualitative findings","volume":"54","author":"Baudinet","year":"","journal-title":"Int. J. Eat. Disord"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3006","article-title":"Perceived change mechanisms in multi-family therapy for anorexia nervosa: a qualitative follow-up study of adolescent and parent experiences","author":"Baudinet","year":"2023","journal-title":"Eur. Eating Disord. Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.652604","article-title":"Adolescent eating disorder day programme treatment models and outcomes: a systematic scoping review","author":"Baudinet","year":"2021","journal-title":"Front. Psychiatry"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-021-00451-3","article-title":"Formulation in eating disorder focused family therapy: why, when and how?","author":"Baudinet","year":"","journal-title":"J. Eat Disord"},{"key":"B6","first-page":"349","article-title":"\u201cFrom treatment models to manuals: maudsley single- and multi-family therapy for adolescent eating disorders,\u201d","volume-title":"Systemic Approaches to Manuals. 1st edition","author":"Baudinet","year":"2022"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-020-00338-9","article-title":"Targeting maladaptive overcontrol with radically open dialectical behaviour therapy in a day programme for adolescents with restrictive eating disorders: an uncontrolled case series","author":"Baudinet","year":"2020","journal-title":"J Eat Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual. Res. Psychol"},{"key":"B9","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1037\/13620-004","article-title":"\u201cThematic analysis,\u201d","volume-title":"APA handbook of Research Methods in Psychology, Vol 2: Research Designs: Quantitative, Qualitative, Neuropsychological, and Biological","author":"Braun","year":"2012"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/14780887.2020.1769238","article-title":"One size fits all? What counts as quality practice in (reflexive) thematic analysis?","volume":"12","author":"Braun","year":"2020","journal-title":"Qual. Res. Psychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1177\/1049732310376520","article-title":"Approaches to and outcomes of dyadic interview analysis","volume":"20","author":"Eisikovits","year":"2010","journal-title":"Qual. Health Res"},{"key":"B12","unstructured":"EislerI.\n            SimicM.\n            BlessittE.\n            DodgeL.\n          MCCAED Team. Maudsley Service Manual for Child and Adolescent Eating Disorder2016"},{"key":"B13","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1080\/10503300902798375","article-title":"Bracketing in qualitative research: conceptual and practical matters","volume":"19","author":"Fischer","year":"2009","journal-title":"Psychother. Res"},{"key":"B14","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1037\/a0036505","article-title":"The role of mentalizing and epistemic trust in the therapeutic relationship","volume":"51","author":"Fonagy","year":"2014","journal-title":"Psychotherapy"},{"key":"B15","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1002\/cpp.1984","article-title":"The experience of caring for or living with an individual with an eating disorder: a meta-synthesis of qualitative studies: experience of caring for someone with AN","volume":"24","author":"Fox","year":"2017","journal-title":"Clin. Psychol. Psychother"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1016\/S0140-6736(13)62411-3","article-title":"Day-patient treatment after short inpatient care versus continued inpatient treatment in adolescents with anorexia nervosa (ANDI): a multicentre, randomised, open-label, non-inferiority trial","volume":"383","author":"Herpertz-Dahlmann","year":"2014","journal-title":"Lancet"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1177\/1609406919870075","article-title":"Social identity map: a reflexivity tool for practicing explicit positionality in critical qualitative research","author":"Jacobson","year":"2019","journal-title":"Int. J. Qual. Methods"},{"key":"B18","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1111\/famp.12242","article-title":"Family therapy for child and adolescent eating disorders: a critical review","volume":"55","author":"Jewell","year":"2016","journal-title":"Fam. Process"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.31219\/osf.io\/ru8sd","article-title":"Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa","volume":"32","author":"Jewell","year":"2021","journal-title":"Eur. Child Adolescent Psychiat."},{"key":"B20","first-page":"406","volume-title":"Radically Open Dialectical Behavior Therapy: Theory and Practice for Treating Disorders of Overcontrol","author":"Lynch","year":"2018"},{"key":"B21","unstructured":"MaidenZ.\n            BakerL.\n            EspieJ.\n            SimicM.\n            TchanturiaK.\n          Group Cognitive Remediation Therapy for Adolescents withAnorexia Nervosa -The Flexible Thinking Group2014"},{"key":"B22","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1192\/bjp.152.3.367","article-title":"Clinical assessment of anorexia nervosa. The Morgan-Russell outcome assessment schedule","volume":"152","author":"Morgan","year":"1988","journal-title":"Br. J. Psychiatry"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-020-00360-x","article-title":"Family members' reflections upon a family-based inpatient treatment program for adolescent anorexia nervosa: a thematic analysis","author":"Nilsen","year":"2021","journal-title":"J. Eat Disord"},{"key":"B24","first-page":"208","article-title":"\u201cAdolescent impressions of family involvement in the treatment of eating disorders,\u201d","volume-title":"Innovations in Family Therapy for Eating Disorders: Novel Treatment Developments, Patient Insights, and the Role of Carers","author":"Parks","year":"2016"},{"key":"B25","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1111\/j.1752-0606.2009.00115.x","article-title":"The Maudsley model of family-based treatment for anorexia nervosa: a qualitative evaluation of parent-to-parent consultation","volume":"35","author":"Rhodes","year":"2009","journal-title":"J. Marital Fam. Ther"},{"key":"B26","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/978-3-319-95121-8_3","article-title":"\u201cEating disorders and mentalizing,\u201d","volume-title":"Hunger: Mentalization-based Treatments for Eating Disorders","author":"Robinson","year":"2019"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1002\/eat.22959","article-title":"Intensive treatment program (ITP): a case series service evaluation of the effectiveness of day patient treatment for adolescents with a restrictive eating disorder","volume":"51","author":"Simic","year":"2018","journal-title":"Int. J. Eating Disord"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-022-00553-6","article-title":"From efficacy to effectiveness: child and adolescent eating disorder treatments in the real world (part 1)\u2014treatment course and outcomes","author":"Simic","year":"2022","journal-title":"J. Eating Disord"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-022-00535-8","article-title":"From efficacy to effectiveness: child and adolescent eating disorder treatments in the real world (Part 2):7-year follow-up","author":"Stewart","year":"2022","journal-title":"J. Eat Disord"},{"key":"B30","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/1467-6427.12067","article-title":"Intensive multi-family therapy for adolescent anorexia nervosa: adolescents' and parents' day-to-day experiences","volume":"37","author":"Voriadaki","year":"2015","journal-title":"J. Fam. Ther"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-017-0156-0","article-title":"Relational containment: exploring the effect of family-based treatment for anorexia on familial relationships","author":"Wallis","year":"2017","journal-title":"J Eat Disord"}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1226605\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T04:05:09Z","timestamp":1691726709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2023.1226605\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":31,"alternative-id":["10.3389\/fpsyg.2023.1226605"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2023.1226605","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,10]]},"article-number":"1226605"}}